Factors associated with non-participation in health screenings amongst Korean older adults: Evidence from a nationally representative survey.

OBJECTIVES: To identify factors associated with non-participation in health screenings amongst Korean older adults, with a focus on digital engagement, environmental accessibility, and end-of-life values. STUDY DESIGN: Cross-sectional study. METHODS: Data from 9136 community-dwelling adults aged ≥65 years in the 2023 National Survey of Older Koreans were analysed using multivariable survey-weighted logistic regression. RESULTS: Non-participation (20.2%) was associated with older age, male sex, unmarried status, poverty, and urban residence. Smartphone use (OR 1.38), dissatisfaction with public transportation (OR 1.16 per 1-point decrease), and life-sustaining treatment (LST) decline (OR 1.35) were independently associated with non-participation. Depression (OR 1.66) and cognitive impairment (OR 1.71) were the strongest modifiable predictors. Sex- and age-stratified analyses revealed differential patterns. CONCLUSIONS: Improving screening uptake requires a multifaceted approach addressing psychological health, digital-era paradoxes, and structural transportation barriers.